Department of Plastic and Reconstructive Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India.
J Burn Care Res. 2022 Jul 1;43(4):808-813. doi: 10.1093/jbcr/irab204.
It is difficult to treat large postburn sequelae (scars and defects) over the face. Available methods include skin grafts, local flaps, tissue expansion, and free flaps. These surgical options should be chosen wisely, depending on individual patient requirements and the area involved. In patients with large postburn scars and defects in which the surrounding tissue is also involved, use of free tissue transfer is extremely useful. A retrospective analysis was done between 2011 and 2019 of 52 cases with extensive facial burn deformities in whom secondary reconstruction was done with free parascapular flap cover in our department. Outcome was assessed by a direct questionnaire. There was no complete flap loss in the series. Two cases were re-explored for venous insufficiency and suffered partial marginal necrosis. Twenty patients had to undergo further debulking procedure. Forty-seven patients were satisfied by the final outcome. Postburn facial deformities are difficult to treat; in many cases, there are no local options, and tissue from different regions is to be used for reconstruction. Free parascapular flaps can be used as an effective method in such cases with a high level of patient satisfaction.
治疗大面积烧伤后后遗症(瘢痕和缺损)非常困难。现有的方法包括植皮、局部皮瓣、组织扩张和游离皮瓣。这些手术选择应根据患者的个体需求和受累区域进行明智选择。对于大面积烧伤瘢痕和缺损且周围组织也受累的患者,游离组织转移极为有用。回顾性分析了 2011 年至 2019 年间我科 52 例广泛面部烧伤畸形患者,采用游离肩胛旁皮瓣覆盖进行二期重建。通过直接问卷调查评估结果。该系列中无完全皮瓣失活。2 例因静脉回流不足而再次探查,发生部分边缘坏死。20 例患者需要进一步进行减容手术。47 例患者对最终结果满意。烧伤后面部畸形难以治疗;在许多情况下,没有局部选择,需要使用来自不同区域的组织进行重建。游离肩胛旁皮瓣可作为此类患者的有效方法,患者满意度高。
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